Drug Shortages Hit Calif.

April 27--Like losing that first tooth or learning to ride a
bike, chickenpox is a right of passage for many children.

But when those dreaded red bumps surface and mom makes a beeline
for the pharmacy, prescription in hand, the last thing she wants to
hear is that the remedy for soothing her itchy kid isn't
available.

For nearly two weeks, A Family Pharmacy in Hesperia has been
trying to get a supply of Acyclovir, an antiviral drug used to
treat chickenpox, shingles, herpes and other conditions that can
lead to blistered skin. All four of the pharmacy's vendors are out,
according to pharmacist Bob Pavlan, with patients still waiting to
start treatment.

The growing shortage of prescription drugs has alarmed experts
in the medical world, with the American Society o f H e a l t h --
Sy s t e m Pharmacists hosting a Drug Shortage Summit in November
to tackle the problem.

R e p o r t s o f n ew drug shortages nearly tripled from 2005
to 2010, according to a recent study from the University of Utah's
Drug Information Service. And most of the shortages haven't been in
treatments for some rare disease, but in medicines for regrettably
common conditions such as cancer or attention-deficit hyperactivity
disorder.

"Last year we had a real problem. There were fairly common
medicines routinely used -- probably 20 to 25 -- that were
unavailable or hard to get," said Curt Emick, pharmacist at the
SuperTarget on Highway 18 in Apple Valley. "Every once in a while
the shortage is so low that we can't get something for a while,
maybe even a month or so."

There's been a significant deficiency of the low blood pressure
medicine Levophed, for example, according to Victor Valley
Community Hospital spokeswoman Lovella Sullivan.

"When there's been a shortage, we've either found another source
to provide them or found another substitute drug that was approved
by the physician," Sullivan said, with vendors such as Cardinal
Health hired to track down replacements.

T h e t r i c k t h e n becomes ensuring that patients receive
the right doses. Dr. Michael Cohen, president of The Institute for
Safe Medication Practices, told WebMD Health News that two patients
recently died after hospitals ran out of morphine and incorrectly
administered another pain reliever.

If the company producing a generic medicine goes offline,
consumers are forced to fork over the difference for a brand-name
drug -- or patients put off treatment altogether.

Even the price of generics has been steadily rising, according
to Pavlan. Almost overnight, he said the cost of Glyburide, used to
treat diabetes, skyrocketed from roughly $35 for a bottle of 1,000
tablets to $192.

"We think that it was only available by one manufacturer,"
Pavlan said, with that company then free to set its own price.

What's more frightening, Pavlan said, is what happens when that
one manufacturer goes offline.

"What many people don't know is that very few of our drugs are
actually produced in the United States," Pavlan said, with a March
study from Prime Healthcare Alliance stating foreign markets such
as China or Croatia supply as much as 80 percent of the raw
materials required to make pharmaceuticals. "When a plant in India
closes down -- is shut down by the FDA -- we're not able to get
that drug."

Even if there are two or three companies making a product, Emick
said if one goes down, the other companies often can't keep up with
the rise in orders. Roughly half of the 60 or so "medically
necessary" drugs on the Food and Drug Administration's shortage
list are there due to increased demand.

Scarcity of a particular active ingredient or a recall by the
FDA can also trigger shortages.

"It's a good thing in a way," Emick said, indicating the federal
government has gotten better at monitoring drugs and pulling
products that may not be safe.

While Pavlan has seen the shortage worsen over the last six
months or so, local hospitals are reporting the drug supply seems
to be improving, with no critical shortages at any of the three
Victor Valley facilities.

"We're really pleased that things seemed to have stabilized in
2011," Jana Bullock, spokeswoman for Desert Valley Hospital, said.
"In 2010 there seemed to be some shortage of prescription drugs,
but the local health care community really partnered together."

Local hospitals have a strong network in place, according to St.
Mary Medical Center spokesman Randy Bevilacqua, so that if one
facility is running short on a medication another will step up and
share.

Many experts fear that generosity may start to dry up, however,
if the shortage continues to escalate the way it has over the last
five years.

In February, Sen. Amy Klobuchar, D-Minn., and Sen. Bob Casey,
D-Pa, introduced the Preserving Access to Life-Saving Medications
Act, which would require prescription drug manufacturers to give
early notification to the FDA of any incident that would likely
result in a drug shortage and to maintain an online list of drugs
that are running low.

"Physicians, pharmacists and patients are currently among the
last to know when an essential drug will no longer be available --
that's not right," Klobuchar said in a statement. "This
common-sense solution will help set up an early warning system so
pharmacists and physicians can prepare in advance and ensure that
patients continue to receive the best care possible."

The bill could face an uphill battle as it moves to committee,
with pharmaceutical companies among the most powerful lobbyists in
the country.

Brooke Edwards may be reached

at (760) 955-5358 or at bedwards@VVDailyPress.com.

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